title: Carotid artery intima-media thickness and distensibility in children and adolescents: reference values and role of body dimensions.
abstract: Carotid intima-media thickness (cIMT) and carotid artery distensibility are reliable screening methods for vascular alterations and the assessment of cardiovascular risk in adult and pediatric cohorts. We sought to establish an international reference data set for the childhood and adolescence period and explore the impact of developmental changes in body dimensions and blood pressure (BP) on carotid wall thickness and elasticity. cIMT, the distensibility coefficient, the incremental modulus of elasticity, and the stiffness index β were assessed in 1155 children aged 6 to 18 years and sex-specific reference charts normalized to age or height were constructed from 1051 nonobese and nonhypertensive children. The role of body dimensions, BP, and family history, as well as the association between cIMT and distensibility, was investigated. cIMT increased and distensibility decreased with age, height, body mass index, and BP. A significant sex difference was apparent from the age of 15 years. Age- and height-normalized cIMT and distensibility values differed in children who are short or tall for their age. By stepwise multivariate analysis, standardized systolic BP and body mass index were independently positively associated with cIMT SD scores (SDS). Systolic BP SDS independently predicted all distensibility measures. Distensibility coefficient SDS was negatively and β SDS positively associated with cIMT SDS, whereas incremental modulus of elasticity was independent of cIMT. Morphological and functional aspects of the common carotid artery are particularly influenced by age, body dimensions, and BP. The reference charts established in this study allow to accurately compare vascular phenotypes of children with chronic conditions with those of healthy children.
authors.affiliation: Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany. anke.doyon@med.uni-heidelberg.de
authors.forename: Anke
authors.initials: A
authors.lastname: Doyon
authors.forename: Daniela
authors.initials: D
authors.lastname: Kracht
authors.forename: Aysun K
authors.initials: AK
authors.lastname: Bayazit
authors.forename: Murat
authors.initials: M
authors.lastname: Deveci
authors.forename: Ali
authors.initials: A
authors.lastname: Duzova
authors.forename: Rafael T
authors.initials: RT
authors.lastname: Krmar
authors.forename: Mieczyslaw
authors.initials: M
authors.lastname: Litwin
authors.forename: Anna
authors.initials: A
authors.lastname: Niemirska
authors.forename: Berna
authors.initials: B
authors.lastname: Oguz
authors.forename: Bernhard M W
authors.initials: BM
authors.lastname: Schmidt
authors.forename: Betul
authors.initials: B
authors.lastname: Sözeri
authors.forename: Uwe
authors.initials: U
authors.lastname: Querfeld
authors.forename: Anette
authors.initials: A
authors.lastname: Melk
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.forename: Elke
authors.initials: E
authors.lastname: Wühl
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000502:physiology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D012307:Risk Factors; D012727:Sex Characteristics; D059289:Vascular Stiffness / Q000502:physiology*
keywords: carotid; child; intima-media thickness; vascular stiffness